What would Pink Viagra Do For You?

Have you ever said to your gynecologist, “Don’t you have a pill to make me feel horny again?” Women are like Porsches with broken starters. We have amazing sexual capacity, enjoy sex once we get started, have high octane orgasms, but sexual urgency is often missing once we’re married or in long-term relationship. Remember how exquisite longing felt? You might agree to have sex but you’d kill to have desire. Help is on its way; pharma’s quest for PINK Viagra is closing in.

Per the recent NY Times article by Daniel Bergner, drug researcher and developer Adriaan Tuiten is trying to develop two similar but slightly different combination medications to fix women’s starters. Both drugs, Librido and Libridos have a coating of testosterone to melt under her tongue before swallowing the rest of the pill. The core of Librido is a compound similar to Viagra and will help make her genitals swell. Libridos’ center has an anti-anxiety drug meant to reduce her inhibition.

There’s some good understanding of female desire behind these compounds:

1) Women lack urgency due to lower testosterone. As a sex therapist, I see couples in good relationships where she is exhausted from caring for children and/or a demanding career but where nothing makes her husband too tired for sex. Imagining that their bodies are similar because of the matched sexual desire that started their relationship, there is enormous frustration between them. He thinks she is withholding and she begins to believe he is demanding. In reality, he has an unfair advantage when it comes to urgency.

A male body has a range 1000-300 nanograms/deciliter of testosterone whereas a woman has only 70/2 ng/dl. At levels of 300 ng/dl, men come to therapy complaining of low libido perhaps only wanting sex only one time a week, no morning erections, poor erections during sex, and Viagra not working well. While women may metabolize and make use of our testosterone more efficiently, there is a huge gender gap in our inherit bounty of this sex drug. We are nearly different species.

Testosterone does often help women’s sexual hunger but I have some questions. Will a sublingual dose immediately increase her desire timed to a romantic evening? Will the dose be small enough to avoid any side effects from increasing her hormone levels?

2) Arousal takes longer for women. Desire often kicks in for a woman when she’s already having sex. About halfway up the mountain of arousal when her genital engorge and her lubrication becomes evident, she starts to crave sex. But getting to the halfway point takes about 20 minutes for most women from a dead start.

Technically Viagra works on the mechanics of erections by increasing vasodilation in the genitals helping couple relations because erectile dysfunction is the most commonly disrupted area of male sexual functioning. It make some biological sense that if a woman is physiologically boosted up the mountain to the point that she starts to want it, then this pill fixes her ignition.

Unfortunately, research by Meredith Chivers has shown that women’s genitals and minds are not as hard-wired together as are men’s. For instance, when shown images that cause a sexual response of vasocongestion in her genitals, women did not always feel subjective arousal. She didn't feel sexual even though her body was turned on. Contrast this with a man. I’m told that if his penis starts to get an erection - by drug, by erotic stimuli, or by the wind - he starts to feel sexy.

I’m hopeful, but a skeptic waiting to see the results of Librido.

3) Libridos (the second drug) also lowers inhibition. Body self-consciousness is a primary reason women avoid sex. They can’t get their mind off their imperfections long enough to melt into the moment. Second, to this is a woman’s feeling of always being behind on her list of things to do. She can’t let go for pleasure’s sake because she feels the ever-present tyranny of her career, household tasks and children’s needs. Partly, her inhibition is about become slothful.

Obviously drugs can't fix our relationships, connect us to a partner, fairly divide family responsibilty, or develop better seduction - things research has also proven that women need for a good sexual relationship. But if those aspects are working, then currently, planning sex, fantasies and imagination are important ways to repair the female starter. I think, however, if the drug works, better buy stock in the company; women are going to want it.

It was interesting to get a better glimpse into some of the biochemistry involved in libido, and see how they are trying to use that. Not sure I'm very comfortable with the idea of my wife using something like this to tamper with her brain chemistry until it is well studied, but, if it really works with manageable side effects (like anti-depressants and similar type drugs), then maybe it will be ok.

Anyway, one thing I really noticed in reading your article and the NY Times article you referenced is that much of the discussion concerns women in long-term, monogamous relationships. It has got me wondering -- thinking of HSDD/SIAD as an actual disorder, it almost seems like length of relationship would be a major indicator (risk factor??) for developing this "condition." In other words, if you've been married longer than x years, a woman's chances of developing SIAD increase by y%. (Obviously, it wouldn't be the only risk factor.)

Dave1 - Yes.. these drugs are quite a ways off in their approval. There are other drugs perhaps closer to market. By year 2, nearly 30% of all married couples are sexless (sex less than 1x a month.) Often they are still young and childless. I do think it's a relational dynamic issue that shuts down sex. More often for women, because though men suffer similar relational frustrations.. their testosterone pushes them to still want release.